Guardian Community Trust, Andover, MA, USA.
The Center for Guardianship Excellence, Andover, MA, USA.
Inquiry. 2022 Jan-Dec;59:469580221086912. doi: 10.1177/00469580221086912.
Hospitals must do more with less, making efficiency a priority. Discharge delays create challenges for acute care hospitals. Some delays are due to patients waiting for a guardian-a person appointed to assist an adult who lacks decision-making capacity. Previous studies examine the burden of excess days in a single academic medical center (AMC); however, these institutions do not represent the entire hospital system. This descriptive study expands upon previous analyses by calculating the financial implications of medically unnecessary days in a state's hospitals to payers. Two models are presented: one calculates the gross patient service revenues required to support excess days; the other calculates the expense to hospitals. Results suggest that substantial funds are required to support excess days. Funds may be better allocated to support the health and well-being of people needing medical care or to address the cause of delays due to waiting for guardianship.
医院必须用更少的资源做更多的事情，因此提高效率成为当务之急。出院延迟给急症护理医院带来了挑战。一些延迟是由于患者等待监护人——被指定协助缺乏决策能力的成年人的人。以前的研究考察了在单一学术医疗中心（AMC）中多余天数的负担；然而，这些机构并不能代表整个医院系统。本描述性研究通过计算医疗保险支付者在州立医院中不必要的多余天数的财务影响，对以前的分析进行了扩展。提出了两种模型：一种计算支持多余天数所需的总患者服务收入；另一种计算医院的费用。结果表明，需要大量资金来支持多余的天数。这些资金可能会更好地用于支持需要医疗护理的人的健康和福祉，或者用于解决因等待监护权而导致的延迟的原因。
